Delaware and the nation are struggling with an addiction epidemic, a fact that is well known.
Less well known is that the addiction epidemic is impacting pregnant women and their infants in increasing numbers. In 2016, there were 431 reports of substance exposed infants to the Department of Services for Children, Youth and Their Families, a sharp increase from the previous year.
The two most common substances found at birth in Delaware are marijuana and opioids; both of which are tied to either short and/or long term negative consequences for the infant. Alcohol exposure, which has the most well-documented long term negative impacts on an infant, is virtually impossible to detect immediately following birth.
In 2016, Delaware was one of the states selected for Substance Exposed Infants In-Depth Technical Assistance (SEI IDTA) funded by the U.S. Department of Substance Abuse and Mental Health Services Administration, and offered by the National Center on Substance Abuse and Child Welfare. The Delaware Child Health Protection Accountability Commission, Department of Health and Social Services, Department of Services for Children, Youth and their Families, March of Dimes, Delaware Healthy Mothers and Infant Consortium, Fetal Alcohol Task Force, Connections, medical providers, and many others have begun work to:
Increase screening of reproductive age women who may be at risk for substance abuse addiction, and increase links to treatment and home visiting services;
Educate physicians on the signs and symptoms of addiction in pregnant patients, and how to refer patients to treatment (See Figures 1 and 2);
Reduce stigma around maternal substance use, and highlight the role of addiction as a chronic disease and the importance of connecting families to support, not punitive measures;
Develop a system where infants born substance exposed and their families receive the medical treatments and supports they need as part of the federally-required “Plan of Safe Care” process. The revised federal rule requires states to address the health and substance use disorder treatment needs of the infant and family.
Link to the Delaware Contraception Access Now (DE CAN) program to help women get access to effective contraception immediately post-partum.
Figure 1.
Fact Sheet: Substance Abuse During Pregnancy, p. 1
Figure 2.
Fact Sheet: Substance Abuse During Pregnancy, p. 2
Pregnant women often do not realize the extent to which alcohol and drug use can harm their baby, and we know that women struggling with addiction are less likely to access prenatal care and significantly more likely to have an unplanned pregnancy.
Under Delaware Code, Title 24, Chapter 17 (Medical Practice Act), Subchapter V, § 1769A, http://delcode.delaware.gov/title24/c017/sc05/index.shtml), medical providers are required to educate their pregnant patients on the dangers of using alcohol and drugs during pregnancy. The Division of Public Health is charged with developing those messages. Working closely with the SEI IDTA partners, DPH created information to meet the requirements of the law, and provide medical providers the tools they need to screen their patients, educate them on the dangers of substance use, and provide links to treatment. This fall the materials will distributed to medical providers serving reproductive age women and placed on the Help is Here website. (See Figures 3, 4, 5, and 6)
Figure 3.
Guidance for Screening Pregnant Patients for Substance Abuse, p. 1
Figure 4.
Guidance for Screening Pregnant Patients for Substance Abuse, p. 2
Figure 5.
Guidance for Screening Pregnant Patients for Substance Abuse, p. 3
Figure 6.
Guidance for Screening Pregnant Patients for Substance Abuse, p. 4
For further information, call the Division of Public Health at 302-744-4704. For further information on preventing, recognizing, and treating addiction, visit www.helpisherede.com.